IV therapy practice quiz

A nurse gives a client 0.25 mg of digoxin instead of the prescribed dose of 0.125 mg. What should the nurse do next?

Assess the client and notify the client's physician.

When a central venous catheter dressing becomes moist or loose, what should a nurse do first?

Remove the dressing, clean the site, and apply a new dressing.

The physician orders 20 mEq of potassium chloride to be added to the IV solution of a client in diabetic ketoacidosis. The nurse is aware that the reason for this is which of the following?

Replacement of electrolyte deficit

A client has requested to have patient-controlled analgesia (PCA) after surgery? When is it appropriate for a client to receive PCA?

The client has the ability to self-administer.

The antidote for heparin is:

protamine sulfate. The antidote for heparin is 1% protamine sulfate. Vitamin K is the antidote for warfarin, an oral anticoagulant. Thrombin is a topical anticoagulant.

A client returns to the room from the postanesthesia care unit after undergoing a right hemicolectomy. The health care provider orders 1 L of dextrose 5% in half-normal saline solution to infuse at 125 ml/hour. The drop factor of the available intravenous tubing is 15 gtt/ml. What is the drip rate in drops per minute? Round your answer to the nearest whole number. (For example: 62)

31 The flow rate is 125 ml/hour or 125 ml/60 minutes. Use this equation to determine the drip rate:125 ml/60 minutes x 15 gtt/1 ml = 31.25 gtt/minute (round down to 31 gtt/minute).

The health care provider has prescribed penicillin for a client admitted to the hospital for treatment of pneumonia. Prior to administering the first dose of penicillin, the nurse should ask the client:

"Have you had a previous allergy to penicillin?"

A physician orders a soap suds enema, 500 ml. What does this amount equal in liters?

0.5 L

The physician prescribes furosemide, 2 mg/kg PO, as a one-time dose for an infant with fluid overload. The infant's documented weight is 14 lb (6.4 kg). The oral solution contains 10 mg/mL. How many milliliters of solution should the nurse administer? Round the answer to the nearest tenth of a millilter.

1.3 Perform the calculation to determine the total dose prescribed: 2 mg/kg = X/6.4 kg. This yields X = 12.8 mg. Then set up the proportion to determine the volume of medication to administer: 10 mg/mL = 12.8 mg/X. Therefore, X = 1.3 mL.

Following surgery, a client is receiving 1,000 mL normal saline (IV) with 40 mEq (40 mmol/L) KCl, which has been ordered to be infused at 125 mL/h. The client states, "My IV hurts." What should the nurse do first?

Assess the IV site for signs of phlebitis, extravasation, or IV-related infection.

A physician orders an I.V. bolus injection of diltiazem hydrochloride for a client with uncontrolled atrial fibrillation. What should the nurse do before administering an I.V. bolus?

Gently aspirate the I.V. catheter to check for a blood return.

When teaching a client about propranolol hydrochloride, the nurse should base the information on the knowledge that propranolol:

blocks beta-adrenergic stimulation and thus causes decreased heart rate, myocardial contractility, and conduction.

Which type of solution, when administered I.V., would cause fluid to shift from body tissues to the bloodstream?

hypertonic

The nurse is caring for a client with an I.V. line. During care of the I.V. line, the nurse would be required to wear protective gloves in which situations? Select all that apply.

when inserting the I.V. When discontinuing the I.V. When changing the I.V. site

A physician orders an infusion of 2,400 ml of I.V. fluid over 24 hours, with half this amount to be infused over the first 10 hours. During the first 10 hours, a client should receive how many milliliters of I.V. fluid per hour?

120 ml/hour First, the nurse determines how many milliliters (half of the total) to administer over the first 10 hours: 2,400 ml ÷ 2 = 1,200 ml. Then the nurse determines how many of these milliliters to deliver per hour: 1,200 ml ÷ 10 hours = 120 ml/hour.

A nurse is preparing to give an average-size 9-year-old child a preoperative I.M. injection. Which size needle should the nurse use?

22G, 1″

A physician orders cefoxitin, 1 g in 100 ml of 5% dextrose in water, to be administered I.V. A nurse determines that the recommended infusion time is 15 to 30 minutes. The available infusion set has a calibration of 10 drops/ml. To infuse cefoxitin over 30 minutes, which drip rate should the nurse use?

33 drops/minute To calculate an I.V. flow rate, the nurse multiplies the number of milliliters to be infused (100 in this case) by the drop factor (10 drops/ml), and then divides by the number of minutes over which the solution is to be infused — 30 minutes. (100 × 10) ÷ 30 = 33 drops/minute

A client with early acute renal failure has anemia, tachycardia, hypotension, and shortness of breath. The health care provider (HCP) has prescribed 2 units of packed red blood cells (RBCs). What should the nurse determine prior to initiating the blood transfusion? Select all that apply.

There is an IV access with the appropriate tubing and normal saline as the priming solution. There is a signed informed consent for transfusion therapy. Blood typing and cross-matching are documented in the medical record. The vital signs have been taken and documented in accordance with facility policy and procedure. The client has an identification bracelet.

A child with type 1 diabetes develops diabetic ketoacidosis and receives a continuous insulin infusion. Which condition represents the greatest risk to this child?

hypokalemia Hypokalemia occurs when insulin administration causes glucose and potassium to move into the cells. Insulin administration doesn't directly affect calcium levels. Hypophosphatemia — not hyperphosphatemia — may occur with insulin administration because phosphorus enters the cells with insulin and potassium. Insulin administration doesn't directly affect sodium levels.

Which is an expected outcome when a client is receiving an IV administration of furosemide?

increased urine output

A client rates the pain level of a migraine an 8 on a scale of 1-10. How would the nurse administer the medication to give the client the quickest relief?

intravenous (IV)

What should a nurse expect to find while assessing the vital signs of a client who has abruptly stopped taking beta-adrenergic blocker?

irregular pulse Abrupt withdrawal of a beta-adrenergic blocker results in rebound cardiac excitation, which causes ventricular arrhythmias and an irregular pulse. Abnormally low blood pressure would be unlikely because beta-adrenergic blockers are used to treat hypertension. Abrupt withdrawal of this medication wouldn't directly affect a client's respiratory rate.

A client is brought to the emergency department with abdominal trauma following an automobile accident. The vital signs are heart rate, 132 bpm; respirations, 28 breaths/min; blood pressure, 84/58 mm Hg; temperature, 97.0° F (36.1° C); oxygen saturation 89% on room air. Which prescription should the nurse implement first?

Administer 1 liter 0.9% saline IV. The client is demonstrating vital signs consistent with fluid volume deficit, likely due to bleeding and/or hypovolemic shock as a result of the automobile accident. The client will need intravenous fluid volume replacement using an isotonic fluid (e.g., 0.9% normal saline) to expand or replace blood volume and normalize vital signs. The other prescriptions can be implemented once the intravenous fluids have been initiated.